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Systematic Review and Meta-Analysis of Tourette Syndrome Prevalence; 1986 to 2022

      Abstract

      Background

      Tourette syndrome (TS) is a disorder characterized by a history of multiple motor tics and the emergence of at least one vocal tic during a period of the disorder. The current investigation sought to clarify the prevalence statistics for TS using a systematic review and meta-analysis.

      Methods

      This systematic review and meta-analysis covered the period between 1986 and 2022. Embase, Scopus, PubMed, Web of Science, and Google Scholar were searched to locate articles pertinent to the study topic. The I2 index was used to examine the heterogeneity of the studies, and a comprehensive meta-analysis was employed to analyze the data.

      Results

      Ultimately, 30 studies (39 outcomes) were included in the meta-analysis and systematic review. The results showed the global prevalence of TS to be 0.5% (95% confidence interval [CI], 0.3% to 0.8%), with the highest rate of spread observed in the Americas at 0.6% (95% CI, 0.2% to 1.6 %). Analyzing the subgroups of the sample revealed that the highest prevalence was associated with the population of children and adolescents at 0.7% (95% CI, 0.4% to 1.4%) and males at 0.5% (95% CI, 0.2% to 1.0%).

      Conclusions

      This comprehensive review and meta-analysis revealed that the prevalence of TS worldwide is sufficiently high, such that attention of medical specialists and health policy makers is warranted.

      Keywords

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      References

        • Leckman J.F.
        • King R.A.
        • Bloch M.H.
        Clinical features of Tourette syndrome and tic disorders.
        J Obsessive Compuls Relat Disord. 2014; 3: 372-379
        • Cohen S.C.
        • Leckman J.F.
        • Bloch M.H.
        Clinical assessment of Tourette syndrome and tic disorders.
        Neurosci Biobehavioral Rev. 2013; 37: 997-1007
        • Robertson M.M.
        • Eapen V.
        • Singer H.S.
        • et al.
        Gilles de la Tourette syndrome.
        Nat Rev Dis Primers. 2017; 3: 1-20
        • Knight T.
        • Steeves T.
        • Day L.
        • Lowerison M.
        • Jette N.
        • Pringsheim T.
        Prevalence of tic disorders: a systematic review and meta-analysis.
        Pediatr Neurol. 2012; 47: 77-90
        • Yang C.
        • Zhang L.
        • Zhu P.
        • Zhu C.
        • Guo Q.
        The prevalence of tic disorders for children in China: a systematic review and meta-analysis.
        Medicine (Baltimore). 2016; 95: e4354
        • American Psychiatric Association D
        Diagnostic and Statistical Manual of Mental Disorders: DSM-5.
        American Psychiatric Association, Washington, DC2013
        • Guha M.
        Diagnostic and statistical manual of mental disorders: DSM-5.
        Reference Rev. 2014; 28: 36-37
        • Ludolph A.G.
        • Roessner V.
        • Münchau A.
        • Müller-Vahl K.
        Tourette syndrome and other tic disorders in childhood, adolescence and adulthood.
        Dtsch Arztebl Int. 2012; 109: 821
        • Roessner V.
        • Ludolph A.G.
        • Mueller-Vahl K.
        • et al.
        Tourette syndrome and other tic disorders in DSM-5–a comment.
        Z Kinder Jugendpsychiatr Psychother. 2014; 42: 129-134
        • Stafford M.
        • Cavanna A.E.
        Prevalence and clinical correlates of self-injurious behavior in Tourette syndrome.
        Neurosci Biobehav Rev. 2020; 113: 299-307
        • Baglioni V.
        • Stornelli M.
        • Molica G.
        • Chiarotti F.
        • Cardona F.
        Prevalence of anxiety disturbs in patients with Tourette syndrome and tic disturb.
        Riv Psichiatr. 2014; 49: 243-250
        • Baron-Cohen S.
        • Scahill V.L.
        • Izaguirre J.
        • Hornsey H.
        • Robertson M.
        The prevalence of Gilles de la Tourette syndrome in children and adolescents with autism: a large scale study.
        Psychol Med. 1999; 29: 1151-1159
        • Gadow K.D.
        • Nolan E.E.
        • Sprafkin J.
        • Schwartz J.
        Tics and psychiatric comorbidity in children and adolescents.
        Dev Med Child Neurol. 2002; 44: 330-338
        • de Alvarenga P.G.
        • de Mathis M.A.
        • Alves A.C.D.
        • et al.
        Clinical features of tic-related obsessive-compulsive disorder: results from a large multicenter study.
        CNS Spectr. 2012; 17: 87-93
        • Kerbeshian J.
        • Burd L.
        Comorbid Down Syndrome, Tourette syndrome and intellectual disability: registry prevalence and developmental course.
        J Intellect Disabil Res. 2000; 44: 60-67
        • Dale R.C.
        Tics and Tourette: a clinical, pathophysiological and etiological review.
        Curr Opin Pediatr. 2017; 29: 665-673
        • Georgitsi M.
        • Willsey A.J.
        • Mathews C.A.
        • Scharf J.M.
        • Paschou P.
        The genetic etiology of Tourette syndrome: large-scale collaborative efforts on the precipice of discovery.
        Front Neurosci. 2016; 10: 351
        • Gloor F.T.
        • Walitza S.
        Tic disorders and Tourette syndrome: current concepts of etiology and treatment in children and adolescents.
        Neuropediatrics. 2016; 47: 084-96
        • Levine J.L.
        • Szejko N.
        • Bloch M.H.
        Meta-analysis: adulthood prevalence of tourette syndrome.
        Prog Neuropsychopharmacol Biol Psychiatry. 2019; 95109675
        • Scharf J.M.
        • Miller L.L.
        • Gauvin C.A.
        • Alabiso J.
        • Mathews C.A.
        • Ben-Shlomo Y.
        Population prevalence of Tourette syndrome: a systematic review and meta-analysis.
        Mov Disord. 2015; 30: 221-228
        • Page M.J.
        • McKenzie J.E.
        • Bossuyt P.M.
        • et al.
        The PRISMA 2020 statement: an updated guideline for reporting systematic reviews.
        BMJ. 2021; : 372
        • Munn Z.
        • Moola S.
        • Lisy K.
        • Riitano D.
        • Tufanaru C.
        Methodological guidance for systematic reviews of observational epidemiological studies reporting prevalence and cumulative incidence data.
        Int J Evid Based Healthc. 2015; 13: 147-153
        • Burd L.
        • Kerbeshian J.
        • Wikenheiser M.
        • Fisher W.
        Prevalence of Gilles de la Tourette's syndrome in north Dakota adults.
        Am J Psychiatry. 1986; 143: 787-788
        • BSc A.M.
        • Sube Banerjee M.
        • MRCPsych M.
        • et al.
        The prevalence of Tourette syndrome in a mainstream school population.
        Dev Med Child Neurol. 1998; 40: 292-296
        • Yang J.
        • Hirsch L.
        • Martino D.
        • Jette N.
        • Roberts J.
        • Pringsheim T.
        The prevalence of diagnosed tourette syndrome in Canada: a national population-based study.
        Mov Disord. 2016; 31: 1658-1663
        • Charania S.N.
        • Danielson M.L.
        • Claussen A.H.
        • Lebrun-Harris L.A.
        • Kaminski J.W.
        • Bitsko R.H.
        Bullying victimization and perpetration among US children with and without Tourette syndrome.
        J Dev Behav Pediatr. 2022; 43: 23-31
        • Scharf J.M.
        • Miller L.L.
        • Mathews C.A.
        • Ben-Shlomo Y.
        Prevalence of Tourette syndrome and chronic tics in the population-based Avon longitudinal study of parents and children cohort.
        J Am Acad Child Adolesc Psychiatry. 2012; 51: 192-201.e5
        • Scahill L.
        • Bitsko R.
        • Visser S.
        • Blumberg S.
        Prevalence of diagnosed Tourette syndrome in persons aged 6-17 years-United States, 2007.
        MMWR Morb Mortal Wkly Rep. 2009; 58: 581-585
        • Khalifa N.
        • von Knorring A.L.
        Prevalence of tic disorders and Tourette syndrome in a Swedish school population.
        Dev Med Child Neurol. 2003; 45: 315-319
        • Alves H.L.
        • Quagliato E.M.
        The prevalence of tic disorders in children and adolescents in Brazil.
        Arq Neuropsiquiatr. 2014; 72: 942-948
        • Kraft J.T.
        • Dalsgaard S.
        • Obel C.
        • Thomsen P.H.
        • Henriksen T.B.
        • Scahill L.
        Prevalence and clinical correlates of tic disorders in a community sample of school-age children.
        Eur Child Adolesc Psychiatry. 2012; 21: 5-13
        • Eapen V.
        • Laker M.
        • Anfield A.
        • Dobbs J.
        • Robertson M.M.
        Prevalence of tics and Tourette syndrome in an inpatient adult psychiatry setting.
        J Psychiatry Neurosci. 2001; 26: 417
        • Giraldo B.O.
        • David M.
        • Sánchez Y.
        • Miranda J.
        • Sierra J.M.
        • Cornejo J.W.
        Prevalence of tics among 6-to 12-year-old schoolchildren in the Itagüi municipality, Colombia, in 2010.
        J Child Neurol. 2013; 28: 1406-1411
        • Jin R.
        • Zheng R.-y.
        • Huang W.-w.
        • et al.
        Epidemiological survey of Tourette syndrome in children and adolescents in Wenzhou of PR China.
        Eur J Epidemiol. 2005; 20: 925-927
        • Heiervang E.
        • Stormark K.M.
        • Lundervold A.J.
        • et al.
        Psychiatric disorders in Norwegian 8-to 10-year-olds: an epidemiological survey of prevalence, risk factors, and service use.
        J Am Acad Child Adolesc Psychiatry. 2007; 46: 438-447
        • Zeitlin H.
        • Robertson M.
        • Hornsey H.
        • Banerjee S.
        The prevalence of Tourette syndrome in 13–14-year-olds in mainstream schools.
        J Child Psychol Psychiatry. 2001; 42: 1035-1039
        • Cubo E.
        • y Galán J.M.T.G.
        • Villaverde V.A.
        • et al.
        Prevalence of tics in schoolchildren in central Spain: a population-based study.
        Pediatr Neurol. 2011; 45: 100-108
        • Janik P.
        • Milanowski Ł.
        • Szejko N.
        Psychogenic tics: clinical characteristics and prevalence.
        Psychiatr Pol. 2014; 48: 835-845
        • Apter A.
        • Pauls D.L.
        • Bleich A.
        • et al.
        An epidemiologic study of Gilles de la Tourette's syndrome in Israel.
        Arch Gen Psychiatry. 1993; 50: 734-738
        • Amiri S.
        • Fakhari A.
        • Golmirzaei J.
        • Mohammadpoorasl A.
        • Abdi S.
        Tourette’s syndrome, chronic tics, and comorbid attention deficit/hyperactivity disorder in elementary students.
        Arch Iran Med. 2012; 15: 76-78
        • Liu L.
        • Jiang Z.G.
        • Li W.
        • Liang H.B.
        • Lin Y.
        Epidemiological investigation of tic disorders among pupils in the Shunde Longjiang area, and their relationship to trace elements.
        Zhongguo Dang Dai Er Ke Za Zhi. 2013; 15: 657-660
        • Zheng R.
        • Jin R.
        • Xu H.
        • et al.
        Study on the prevalence of tic disorders in schoolchildren aged 7-16 years old in Wenzhou.
        Zhonghua Liu Xing Bing Xue Za Zhi. 2004; 25: 745-747
        • Kurlan R.
        • McDermott M.
        • Deeley C.
        • et al.
        Prevalence of tics in schoolchildren and association with placement in special education.
        Neurology. 2001; 57: 1383-1388
        • Caine E.
        • McBride M.
        • Chiverton P.
        • Bamford K.
        • Rediess S.
        • Shiao J.
        Tourette's syndrome in Monroe County school children.
        Neurology. 1988; 38: 472
        • Burd L.
        • Kerbeshian J.
        • Wikenheiser M.
        • Fisher W.
        A prevalence study of Gilles de la Tourette syndrome in North Dakota school-age children.
        J Am Acad Child Psychiatry. 1986; 25: 552-553
        • Comings D.E.
        • Himes J.A.
        • Comings B.G.
        An epidemiologic study of Tourette's syndrome in a single school district.
        J Clin Psychiatry. 1990; 51: 463-469
        • Wong C.
        • Lau J.T.
        Psychiatric morbidity in a Chinese primary school in Hong Kong.
        Aust N Z J Psychiatry. 1992; 26: 459-466
        • Wang H.-S.
        • Kuo M.-F.
        Tourette's syndrome in Taiwan: an epidemiological study of tic disorders in an elementary school at Taipei County.
        Brain Dev. 2003; 25: S29-S31
        • Schlander M.
        • Schwarz O.
        • Rothenberger A.
        • Roessner V.
        Tic disorders: administrative prevalence and co-occurrence with attention-deficit/hyperactivity disorder in a German community sample.
        Eur Psychiatry. 2011; 26: 370-374
        • Kadesjö B.
        • Gillberg C.
        Tourette's disorder: epidemiology and comorbidity in primary school children.
        J Am Acad Child Adolesc Psychiatry. 2000; 39: 548-555
        • Nomoto F.
        • Machiyama Y.
        An epidemiological study of tics.
        Jpn Psychiatry Neurol. 1990; 44: 649-655
        • Munce S.E.
        • Pitzul K.B.
        • Guilcher S.J.
        • et al.
        Health and community-based services for individuals with neurological conditions.
        Can J Neurol Sci. 2017; 44: 670-675
        • Edition F.
        Diagnostic and statistical manual of mental disorders.
        Am Psychiatr Assoc. 2013; 21: 591-643